论文部分内容阅读
目的探讨肝硬化患者血氨水平在合并不同消化道症状中的变化及治疗前后变化的临床意义。方法 216例肝硬化患者作为观察组,其中单纯肝硬化111例,肝硬化伴消化道出血58例,肝硬化伴便秘47例,对105例伴消化道症状的患者进行酸化肠道法治疗。另外选取75例单纯消化道出血患者,80例单纯便秘患者及进行体检的60例正常人作为对照。比较各种类型患者血氨水平差异及经酸化肠道治疗后的变化情况。结果单纯性消化道出血、单纯便秘患者与正常人血氨水平比较差异无统计学意义(P>0.05);单纯肝硬化、肝硬化伴消化道出血、肝硬化伴便秘患者血氨水平明显高于正常人(P<0.05);肝硬化伴消化道出血、肝硬化伴便秘患者血氨水平明显高于单纯肝硬化患者(P<0.05);肝硬化伴便秘患者血氨水平明显高于肝硬化伴消化道出血患者(P<0.05);伴有消化道症状的患者治疗2 d后血氨水平明显低于治疗前(P<0.05)。结论对肝硬化患者进行血氨检测并观察其变化能有效指导和制定治疗方案。
Objective To investigate the clinical significance of the change of serum ammonia level in patients with cirrhosis complicated with different gastrointestinal symptoms and the changes before and after treatment. Methods Two hundred and sixty-one patients with cirrhosis were selected as the observation group, including 111 cases of simple cirrhosis, 58 cases of liver cirrhosis with gastrointestinal hemorrhage, 47 cases of liver cirrhosis and constipation, and 105 cases of patients with gastrointestinal symptoms were treated with the method of acidizing intestinal tract. In addition, 75 patients with simple digestive tract hemorrhage, 80 simple constipation patients and 60 healthy controls were selected as controls. Compare the difference of blood ammonia level of all kinds of patients and the changes after acidified intestinal tract treatment. Results There was no significant difference in blood ammonia level between simple constipation and normal subjects (P> 0.05). The levels of serum ammonia in patients with simple cirrhosis, liver cirrhosis with gastrointestinal bleeding and cirrhosis with constipation were significantly higher than those with simple constipation (P <0.05). The level of serum ammonia in cirrhosis with cirrhosis and constipation was significantly higher than that in patients with cirrhosis (P <0.05). The level of serum ammonia in patients with cirrhosis and constipation was significantly higher than that in patients with cirrhosis Patients with gastrointestinal bleeding (P <0.05); patients with gastrointestinal symptoms after 2 d of treatment of blood ammonia levels were significantly lower than before treatment (P <0.05). Conclusion The detection of blood ammonia in patients with cirrhosis and observation of the changes can effectively guide and formulate the treatment plan.